Urinary Infections In Women Research Articles

Screening for Low-Tract Genital Infections in Women with Threatened Preterm Labor: Which Role?

Objectives: The aim of this study was to evaluate the possible relationship between cultural specimens and preterm birth in women admitted for threatened preterm labor. Preterm birth is the leading cause of neonatal mortality and antenatal hospitalization; several risk factors including intrauterine infections have been identified, but its real causes remain poorly understood. Design: This is a retrospective, multicenter, cohort study including 250 women admitted for threatened preterm labor. Methods, Participants/Materials, Setting: All women admitted for threatened preterm labor, i.e., presenting with cervical changes and uterine activity before 37 weeks at the obstetrics unit of the hospitals of Modena, Monza, Carate, and Vimercate were included in the study. We excluded twin pregnancies and cases with preterm premature rupture of membranes at admission. Data about maternal history, pregnancy complications, cervical length, vaginal swabs, and urine culture at admission and gestational age at delivery were collected from clinical records in order to compare the incidence of preterm birth according to some known risk factors, cervical length, and microbiological test at admission. Results: 250 women were included in the study; preterm birth at less than 37 weeks occurred in 44.4% women admitted for threatened preterm labor. The incidence of preterm birth was not different between those with a positive or a negative vaginal swab (48.3 vs. 38.4%, p = 0.22) or positive versus negative urine culture (31.8 vs. 42.1%, p = 0.23) at admission. A shorter cervical length at admission was found in women with subsequent preterm birth (17 vs. 19.5 mm, p = 0.03). Cervical length <15 mm (OR 1.82, 95% CI: 1.03–3.23, p = 0.039) predicted the risk of preterm birth. Furthermore, only the history of a previous preterm birth (p = 0.02) and a previous uterine curettage (p = 0.045) was associated with preterm birth. Limitations: The observational and retrospective nature of the study and its small sample size are important limitations of the study. Moreover, women were not systematically or randomly assigned to the screening for vaginal or urinary infections. Conclusions: There is no evidence that the search for vaginal or urinary infections in women admitted for threatened preterm labor is helpful to identify those at increased risk of preterm birth. Although several studies have explored the role of screening for bacterial vaginosis in asymptomatic women and some studies evaluated vaginal or urinary infections in women with preterm birth, none of them focused on the possible role of microbiological specimens as a predictive tool in women admitted for threatened PTL. No association was found in our study, but prospective randomized controlled trials are required to confirm the results of this observation.

Опыт применения гормонально-пробиотической терапии в комплексном лечении женщин в пери- и постменопаузальном периодах с хроническим рецидивирующим бактериальным циститом на фоне вульвовагинальной атрофии

Lower urinary tract infections (LUTI) are one of the most common diseases among women. The risk of LUTI increases with the onset of peri- and postmenopause. Vulvovaginal atrophy occurs in 30% of women aged 55 years and 75% of women aged 70 years. Currently, local hormone therapy is the main method of its treatment. However, different variants of complex therapy are also used. The study included 60 women aged with the diagnosis: "Postmenopausal atrophic vaginitis. Chronic recurrent bacterial cystitis in the acute stage". The patients were divided into 2 groups of 30 people. In group 1 was carried out etiotropic antibiotic therapy in combination with local use of single-agent preparation or estriol for 3 months. In group 2, the patients received antibiotics in combination with Triozhinal for 3 months. The effectiveness was monitored on the 1st and 7th day of therapy, as well as 3 months after the start of treatment. At admission in both groups there were signs of vulvovaginal atrophy and exacerbation of chronic cystitis. Complex therapy with Triozhinal, containing lyophilized culture of lactobacilli L. casei rhamnosus Doderleini, contributed to the normalization of PH, restoration of vaginal biocinosis, and, consequently, reduce the severity of complaints of dryness and burning in the vagina, dyspareunia. Thus, despite the reduction of symptoms in the majority of women, the proportion of such patients in group 2 was higher and amounted to 96.7% against 83.3% in group 1. Supportive reception of the drug for 3 months. it allowed to preserve the normocinosis of the vagina until the restoration of its trophic, as well as to reduce the frequency of bacteriuria and leukocyturia by 20% compared with the results of group 1, and to significantly reduce the number of relapses of infection (p<0.05). Triozhinal improves the results of treatment of recurrent urinary infection in women with vulvovaginal atrophy in peri- and postmenopausal and can be recommended for use in combination therapy.

Опыт применения гормонально-пробиотической терапии в комплексном лечении женщин в пери- и постменопаузальном периодах с хроническим рецидивирующим бактериальным циститом на фоне вульвовагинальной атрофии

Lower urinary tract infections (LUTI) are one of the most common diseases among women. The risk of LUTI increases with the onset of peri- and postmenopause. Vulvovaginal atrophy occurs in 30% of women aged 55 years and 75% of women aged 70 years. Currently, local hormone therapy is the main method of its treatment. However, different variants of complex therapy are also used.The study included 60 women aged with the diagnosis: "Postmenopausal atrophic vaginitis. Chronic recurrent bacterial cystitis in the acute stage". The patients were divided into 2 groups of 30 people. In group 1 was carried out etiotropic antibiotic therapy in combination with local use of single-agent preparation or estriol for 3 months. In group 2, the patients received antibiotics in combination with Triozhinal for 3 months. The effectiveness was monitored on the 1st and 7th day of therapy, as well as 3 months after the start of treatment.At admission in both groups there were signs of vulvovaginal atrophy and exacerbation of chronic cystitis. Complex therapy with Triozhinal, containing lyophilized culture of lactobacilli L. casei rhamnosus Doderleini, contributed to the normalization of PH, restoration of vaginal biocinosis, and, consequently, reduce the severity of complaints of dryness and burning in the vagina, dyspareunia. Thus, despite the reduction of symptoms in the majority of women, the proportion of such patients in group 2 was higher and amounted to 96.7% against 83.3% in group 1. Supportive reception of the drug for 3 months. it allowed to preserve the normocinosis of the vagina until the restoration of its trophic, as well as to reduce the frequency of bacteriuria and leukocyturia by 20% compared with the results of group 1, and to significantly reduce the number of relapses of infection (p<0.05).Triozhinal improves the results of treatment of recurrent urinary infection in women with vulvovaginal atrophy in peri- and postmenopausal and can be recommended for use in combination therapy.

Controlled drug delivery of ciprofloxacin from ultrasonic hydrogel

AbstractCiprofloxacin is an antibacterial fluoroquinolone that stops the DNA synthesis, after penetration into the bacterial cells. This drug is applied in the curing of bacterial infections, as well as in antibiotics to treat urinary infections in women, infectious diarrhea and typhoid fever. The objective of the present work is to study controlled release of ciprofloxacin by hydrogel prepared by ultrasound. For this, first the swelling properties of hydrogel and then the absorption of drug were evaluated. The swollen hydrogel was dried in oven (50°C) and was ready for release experiments. During release, the loaded powder of the hydrogel was added to a buffer solution of pH 7.4, similar to human body condition. Then drug concentration was measured using a UV-visible (UV-Vis) spectrophotometer and a calibration curve. The results showed that the hydrogel is sensitive to pH, which makes it a good candidate for ciprofloxacin delivery in intestine. In addition, it was shown that the drug absorption is proportional with the swelling content of the hydrogel and the drug concentration in the loading process. The chemical structure and morphology of the hydrogels and loaded drug were characterized using Fourier transform infrared, UV-Vis, scanning electronic microscopy and thermal gravimetric analysis spectroscopy. According to the results presented here, acrylic-based hydrogels can be used in biomedical fields, especially for controlled drug release.

Clean, Intermittent Self-Catheterization in the Treatment of Urinary Tract Disease.

No AccessJournal of UrologyCatheterization1 Feb 2017Clean, Intermittent Self-Catheterization in the Treatment of Urinary Tract Disease Jack Lapides, Ananias C. Diokno, Sherman J. Silber, and Bette S. Lowe Jack LapidesJack Lapides More articles by this author , Ananias C. DioknoAnanias C. Diokno More articles by this author , Sherman J. SilberSherman J. Silber More articles by this author , and Bette S. LoweBette S. Lowe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.10.097AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail References 1 Lapides, J.: Role of hydrostatic pressure and distention in urinary tract infection. In: Progress in Pyelonephritis. Edited by E. H. Kass. Philadelphia: F. A. Davis Co., p. 578, 1965. Google Scholar 2 Mehrotra, R. M. L.: An experimental study of the vesical circulation during distension and in cystitis. J Path Bact., 66: 79, 1953. Google Scholar 3 Lapides, J., Costello, R. T., Jr., Zierdt, D. K. and Stone, T. E.: Primary cause and treatment of recurrent urinary infection in women: preliminary report. J Urol., 100: 552, 1968. Google Scholar 4 Lapides, J. and Costello, R. T., Jr.: Uninhibited neurogenic bladder: a common cause for recurrent urinary infection in normal women. J Urol., 101: 539, 1969. Google Scholar 5 Lapides, J. and Diokno, A. C.: Persistence of the infant bladder as a cause for urinary infection in girls. J Urol., 103: 243, 1970. Google Scholar 6 Schwarz, H.: Renal invasion by E. coli via a mucosal lesion of the sigmoid colon: a demonstration utilizing methods of autoradiography and group-specific serologic typing. Invest Urol., 6: 98, 1968. Google Scholar 7 Campbell, M. F.: Urologic complications of anorectal and colon surgery. Amer J Proctol., 12: 43, 1961. Google Scholar 8 Lapides, J.: Urinary diversion. Surgery, 69: 142, 1971. Google Scholar 9 Guttmann, L. and Frankel, H.: The value of intermittent catheterization in the early management of traumatic paraplegic and tetraplegia. Paraplegia, 4: 63, 1966. Google Scholar © 2002 by American Urological Association, Inc.®FiguresReferencesRelatedDetails Volume 197Issue 2SFebruary 2017Page: S122-S124 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.®MetricsAuthor Information Jack Lapides More articles by this author Ananias C. Diokno More articles by this author Sherman J. Silber More articles by this author Bette S. Lowe More articles by this author Expand All Advertisement PDF downloadLoading ...

Uncomplicated urinary infection in women: diagnosis

Uncomplicated urinary infection in women: diagnosis

Uncomplicated urinary infection in women: diagnosis

Uncomplicated urinary infection in women: diagnosis

Prophylaxis in Female Urinary Infections in Women

Recurrent urinary tract infections (UTI) in women cost billions of euro annually. E. Coli causes 70–95% of these infections and it has been observed, in vitro and in vivo, to have the capability to develop bacterial biofilms in the bladder: polysaccharide-rich matrix. At the present, the only way to overcome this mucopolysaccaride barrier is to administer long repeated cycles of chemotherapy. We submit prophylaxis to patients with recurrent UTI to sterilize urine for at least 6 consecutive months. Materials and Methods 42 women with recurrent UTI have been selected according to: urine culture, vaginal swabs, and DNA-probe for Chlamydia, Gonococcus, Mycoplasma. After giving informed consent patients were assigned to treatment group A and B. For the first 10 days both groups received ciprofloxacin 500 mg bid, and then group A received ciprofloxacin 250 mg on alternate days and 1 cpr before every sexual intercourse. The group B received placebo in the same modality. Every sexual intercourse had to be safe. All the patients, after the initial screening, repeated an urine culture every 10 days for the first 6 months and every 20 days for the next 6 months. The statistical analysis was performed by chi-square test. Results 44 patients finished the study. 23 pt of group A had sterile urine for the first 6 months of the study and 81% for the next 6 months; 1/23 had 2 episodes of symptomatic UTI. 71% of the 21 patients of group B had symptomatic bacteriuria 20 days after the first treatment (p&lt;0.001). 16/21 patients had symptomatic UTI in the first 6 months of the study and the 90% in the 12 months of the study (p&lt;0.001), in spite of every poussèe was treated with the same antibiotic scheme. Conclusions This kind of prophylaxis has few collateral effects, and it appears to be effective in the treatment of recurrent UTI in women.

Activité de l’acide nalidixique et des fluoroquinolones sur des souches de Escherichia coli isolées d’infections urinaires non compliquées (réseau TSN – France, 1999 – 2001)

Objective. – The authors studied the susceptibility of 1,647 non-repeat isolates of Escherichia coli to quinolones and fluoroquinolones. Method. – The strains were isolated from non-complicated urinary infections in women 18–64 years of age. Data was provided by the TSN Database France, a real time electronic database which collects antibiotic susceptibility results and patient demographic data. The data was collected from 1999 to 2001 in 63 French hospital laboratories, each using their own routine test methods. Quantitative data was interpreted (S, I, R) according to CA-SFM breakpoint guidelines. Results. – Ninety-eight and 94,6 % of the strains were susceptible to ciprofloxacin and nalidixic acid respectively. Cross resistance was assessed as well as intrinsic difference in activity within the fluoroquinolone class. Current fluoroquinolones are still highly efficient, and ciprofloxacin is the most active. Conclusion. – Since 1996, little change in resistance to fluoroquinolones has been observed. These results confirm the choice of fluoroquinolones as first intention therapy as recommended by consensus conferences.

Norfloxacin prophylaxis for acute recurrent uncomplicated urinary tract infection in women

Long-term low dose antimicrobial prophylaxis is effective for the prevention of recurrent uncomplicated urinary infections in women. The fluoroquinolone antimicrobials, including norfloxacin, have an in vitro spectrum effective for most uropathogens, and generally achieve high concentrations in the urine. In addition, they are effective for eradication of aerobic Gram-negative flora from the gut. These features suggest these antimicrobials should be effective agents for antimicrobial prophylaxis for urinary infection. Only norfloxacin has been studied in clinical trials to date. In two of the three studies reported, norfloxacin was effective for prophylaxis compared to placebo. In the third study, it was as effective as nitrofurantoin macrocrystals. Infections which occurred during prophylaxis were with organisms resistant to norfloxacin, particularly Enterococcus faecalis and Pseudomonas aeruginosa. Norfloxacin is effective for the prevention of recurrent uncomplicated urinary infections in women. Further studies comparing it to standard regimens are required to identify its specific niche in the management of this common problem.

Prevention of urinary tract infections

Potential candidates for measures designed to prevent urinary tract infections include (1) women (or girls) with frequent exogenous reinfections; (2) pregnant women; (3) hospitalized patients with short-term indwelling catheters; (4) men with chronic bacterial prostatitis; (5) patients with neurogenic bladders being managed with either intermittent catheterization or chronic indwelling catheters; and (6) men undergoing urologic surgery. Patients in the first three categories represent the vast majority of men and women with preventable urinary tract infections. On the basis of our current understanding of the pathogenesis of urinary infections in women, potential preventive measures can be envisioned. To date, the most successful methods in susceptible women include continuous low-dose antimicrobial prophylaxis or postintercourse antibiotic prophylaxis. In controlled clinical trials, the efficacy of low-dose trimethoprim-sulfamethoxazole, trimethoprim, or nitrofurantoin has repeatedly been demonstrated, and the cost effectiveness of this approach has also been established. An alternative strategy, intermittent, self-administered, single-dose antimicrobial therapy, may be useful in selected circumstances. Screening of high-risk patients for asymptomatic infections has largely been abandoned except in pregnant women in whom this practice remains an important preventive measure. Exciting newer approaches to prevention based on studies clarifying the fimbrial structures mediating bacterial adherence to receptors on uroepithelial cells include the use of receptor analogs and immunoprophylaxis, but these approaches are not yet of demonstrated clinical efficacy.

Long-term Prophylaxis of Urinary Infections in Women

Long-term Prophylaxis of Urinary Infections in Women

Seasonality of symptomatic bacterial urinary infections in women.

Bacterial infections of the female urinary tract (UTI) are a frequent clinical problem. A chance observation, supported by a one year survey reported from another country, suggested that UTI presented to the general practitioner more frequently in the summer. A retrospective survey, covering three consecutive years, was carried out to test this observation. The records of all women reported as attending this practice with a UTI showed that 213 culture positive episodes occurred in the third calendar quarter of each year. Edward's test for cyclic variation showed a significant peaking in August. These results indicate a definite seasonal fluctuation in the frequency with which symptomatic UTIs present to general practitioners in this practice. The clinical and epidemiological significance of this phenomenon remains to be determined.

The Bacterial Flora of the Vaginal Vestibule, Urethra and Vagina in Premenopausal Women with Recurrent Urinary Tract Infections

Gram-negative enteric bacteria, mainly Escherichia coli, form the predominant microbial flora of the introitus, vagina and urethra in women with a normal genitourinary tract but who are prone to suffer recurrent urinary infections. The infections in these women tend to occur in greater numbers and persist for long intervals, compared to normal control women who never experience urinary infections and in whom the main introital, vaginal and urethral microbial flora consists of lactobacilli and staphylococci. The appearance of gram-negative enterobacteria in the normal and control subjects usually is a rare and transitory event.The majority of urinary tract infections that developed in our population during this study was preceded by a persistent similar gram-negative vulvovaginal and urethral microbial flora. However, prolonged spontaneous intervals occurred occasionally during which the introital, vaginal and urethral cultures were free of gram-negative bacteria, with simultaneous intervals free of infection. Nevertheless, all of these intervals ended with documented urinary tract infections.The introital culture is a reliable mirror of the vulvovaginal and urethral microbial flora and, therefore, it is adequate in the study of urinary infections in women.

Prevention of Recurrent Urinary Infections in Women: A Comparative Trial Between Nitrofurantoin and Methenamine Hippurate

We treated 99 female patients suffering from recurrent urinary infections with either 1gm. methenamine hippurate every 12 hours or 50mg. nitrofurantoin every 12 hours for intervals of up to 1 year. Monthly microbiological and clinical surveillance was done. Both treatments were effective in reducing the incidence of symptomatic attacks, with nitrofurantoin being more effective. The protective effect of prophylaxis continued after treatment had stopped, suggesting that a permanent beneficial action had been produced. Especially during the first month of treatment methenamine hippurate was tolerated better than nitrofurantoin: 28 per cent discontinued therapy with the latter owing to nausea.

Single dose treatment of acute urinary infections in women.

Single dose treatment of acute urinary infections in women.

Role of bacterial growth rates in the epidemiology and pathogenesis of urinary infections in women

The mean minimum generation time in shake culture in urine of 6 urinary isolates of Escherichia coli (21.7 +/- 0.6 min) was significantly shorter (P = 0.0003) than that of 14 isolates of less common urinary pathogens (46.0 +/- 18.6 min). Mixed populations of approximately equal numbers of E. coli cells paired with other urinary, fecal, and urethral organisms were introduced into a laboratory model of the lower human urinary tract. This model used urine as a medium and reproduced some features of the balance between bacterial growth and the flushing effect of urine. After 24 h E. coli formed greater than or equal to 99% of the bacterial population in the bladder model for 16 our of 18 pairs of isolates examined. Relatively high oxygen tensions in urine sample from 18 healthy women (10.9 +/- 22. kPA) and 18 infected patients (8.0 +/- 4.3 kPa) may explain why anaerobic urinary infections are uncommon. The rapid growth rate of E. coli may be one explanation why it is the commonest cause of urinary infection even though it is relatively uncommon at the urethral meatus.

Studies of Introital Colonization in Women with Recurrent Urinary Infections. VIII. The Role of Bacterial Interference

The non-pathogenic aerobic bacteria in 97 quantitative introital cultures from 11 women with documented recurrent bacteriuria were compared statistically to those in 100 quantitative introital cultures from 10 control women with no history of bacteriuria. The colonization incidence of the non-pathogenic organisms was not statistically different for the 2 groups, except for gamma hemolytic Streptococcus (p equals 0.002). No strongly significant correlations were demonstrated between the colonization incidence of Enterobacteriaceae or enterococci and the colonization incidence of the common non-pathogenic organisms, when analyzed for the bacteriuric and control groups or when analyzed for the individual cultures of each subject. A quantitative analysis of the 197 individual cultures failed to establish correlations between the presence of the common non-pathogenic organisms and Enterobacteriaceae or enterococci. The susceptibility of the vaginal introitus to colonization by urinary pathogens cannot be explained by interrelationships between these pathogens and the normal aerobic vaginal flora.

Studies of Introital Colonization in Women with Recurrent Urinary Infections. VII. The Role of Bacterial Adherence

The susceptibility of the vaginal introitus to colonization by enterobacteria appears to be the biologic defect that separates women who experience recurrent urinary infection from those resistant to recurrent infection. Colonization of a mucosal surface is mediated in part by the ability of an organism to adhere to the surface. We describe an in vitro model that measures the capacity of different bacterial species to adhere to human vaginal epithelial cells. Different bacteria are demonstrated to vary in their adhesive properties. Escherichia coli is shown to adhere more readily to vaginal cells from women with recurrent urinary infection than to similar cells from control women resistant to urinary infection (p less than 0.001). These studies suggest that biologic susceptibility to recurrent urinary infections in women is related to a defect at the cellular level that encourages or favors bacterial adherence.

A controlled study of antimicrobial prophylaxis of recurrent urinary infection in women

A controlled study of antimicrobial prophylaxis of recurrent urinary infection in women